Individual
BRYNNA SCOUT FULLERTON VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S AIRPARK RD, COTTONWOOD, AZ 86326-4182
(928) 639-2694
Mailing address
101 AIRPARK ROAD, SUITE M, COTTONWOOD, AZ 86326
(928) 639-2694
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
SLPA14693
AZ
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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